HomeMy WebLinkAboutPermit Mechanical 2002-8-20 (2)
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I Job# 02-01005-01 I
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TRANS#:01-0010345
DATE:AUG 20 2002
AMT REeD:l $ 100.00
CHANGE:$ 38.25
CASHIER:061
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CITY OF SPRINGFIELD, OREGON
COMMERCIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 02-01005-01
225 Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 3655 Franklin Blvd Eug
Assessors Map#: 17033431
Lot: Block: Addition:
Tax Lot #: 00701
Subdivision:
Owner:
Address:
C & M Pump Co
36191/2 Franklin Blvd
Phone Number: 541-726-5586
Install gas wall furnace
City/State/Zip: Eugene, OR 97403-2357
Value: $0
Ulfes yOU to
_ .oregon laW feq on UtiliW
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. .I'''W rules l:1Uvt"'--rhO"e ru\e~ '" v ;'52-001-
Contractor 10 Registration\#f. Expiration~D3tIP \ \~\hone
Automatic Heat / Eugene Heating Nooti~9~;~.001-0bOt1a?J)~~2~~5)1 tM r~G~' rt-726-7654
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3675 Franklin Blvd, Eugene, OR 97403 0090. '(oU !flay tedNote:~~e~~ tilicatiOn
,.. _ ,,,",0 r:.eO . ....I.hl ,,,0
(;<1"'"'' the Qregu" V' . "44).
Office Use nUlllu"rlor". 1 800-332.2<>
CenterlS . . .
# Of BUlldmgs:
Occupancy Group:
Heat Source:
Sq. Footage:
New
Scope Of Work: Mechanical
Contractor Type
Mechanical Contr
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Land Use:
Zoning Code:
Bedrooms:
Range:
To request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
working day.
Rough Gas
Rough Mechanical
Final Gas
Final Mechanical
Required InspectiOt~tn\j't: E~PIRc It ,lit: W~CIl
I Mechanical ~\ II; PERMll S\1r>.ll 1\1\S PERMll IS MOt
-A~er line is installed and capped if not aR~,\~e~1IiQlp~IQliB,'\'3r>.MOOMEO fOR
-Prior to cover.. . MEMCEO OR I~'A
-When all gas work is complete. COM 180 Or>.\{ PERIOD.
-When all mechanical work is complete. /l.N\{
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
,Area (Sq. Feet)
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
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Job# 02-01005-01
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Fee
Paid On Receipt#
I Mechanical
08/20/2002 10345
08/20/2002 10345
08/20/2002 10345
08/20/2002 10345
08/20/2002 10345
08/20/2002 10345
Value/Quantity
Fee Amount
One to Four Outlets
Minimum Mechanical Permit
8% Administrative Fee - Mechanical
Less than 100,000 BTU
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
1
$4.00
$29.00
$3.60
$12.00
$10.00
$3.15
$61.75
$61.75
1
Grand Total
By signature, I state and agree that I have carefully examined the completed application and do
hereby certify that all information herein is true and correct. and I further certify that any and all work
performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of
the State of Oregon. I further state that only contractors and employees who are in compliance with
ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are
requested_at the pr<;pr ~e Jfd "a~ the project address is readable from the street.
'7UAA'dl>1/ ~~
Signature C
<;? - 2f) - 02-
Date